| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | UNITEDHEALTHCARE INSURANCE COMPANY | $58K | — | $58K | 3.90% |
| ACRISURE LLC3 Filed as: ACRISURE SW PARTNERS INS SERV LLC | 611 ANTON BLVD STE 1400 COSTA MESA, CA 92626 | UNITEDHEALTHCARE INSURANCE COMPANY | $21K | — | $21K | 1.41% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC CALIFORNIA | 669 RIVER DRIVE CENTER II STE 305 ELMWOOD PARK, NJ 07407 | UNITEDHEALTHCARE INSURANCE COMPANY | $17K | — | $17K | 1.16% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFITS GROUP INC - CA | 669 RIVER DRIVE CENTER II STE 305 ELMWOOD PARK, NJ 07407 | UNITEDHEALTHCARE INSURANCE COMPANY | $7K | — | $7K | 0.50% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA DBA AHERN | 16835 W BERNARDO DR STE 212 SAN DIEGO, CA 92127 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $17K | — | $17K | 13.83% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | DBA AHERN INS 16835 W BERNARDO DR, STE 212 SAN DIEGO, CA 92127 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | — | $7K | 13.76% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC DBA | AHERN INS 16835 BERNARDO DR, STE 212 SAN DIEGO, CA 92127 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 13.88% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC DBA | AHERN INS 16835 W BERNARDO DR, STE 212 SAN DIEGO, CA 92127 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $853 | — | $853 | 13.80% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 113 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 268 | $1.5M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 268 | $1.5M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 268 | $1.5M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 113 | $126K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 113 | $14K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 113 | $53K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 113 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 268 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.